"I grew up knowing cancer was in my future. My grandmother died of breast cancer before I was born, and although my mother tried chemo and special diets, she passed away when I was 26.

As I started to near my 40s, I decided it was time for me to get tested for the BRCA mutation. Even though I had prepared for it my whole life, I was stunned when they came back positive. There’s something about hearing that you have an 87% chance of getting breast cancer and a 50% of getting ovarian cancer that you can never prepare for.

At that point, I decided I needed to do what my mother and grandmother hadn’t: get a double mastectomy. I felt lucky I had that choice. When I told family and friends about my decision, half told me I was extremely brave, and the other half thought I was nuts. But BRCA wasn’t really in the news yet. Angelina Jolie had not come forward about her experience. Even if other people did not understand, I needed to undergo the procedure. I thought about my kids, and how I couldn't let cancer take me from them.

My mother was so quiet about her cancer experience, which is why I speak out. I will continue to be strong for my kids because I want them to be brave, too."

In honor of Breast Cancer Awareness Month, TIME photographed 15 women who chose to have preventative double mastectomies after learning they carry the BRCA1 or BRCA2 mutations, years before Angelina Jolie’s New York Times Op-ed renewed the conversation about the genetic risk factors and surgical decisions. These mutations can increase the risk of breast cancer by up to 80% and the risk of ovarian cancer by 45%, which prompts many women to decide to remove their breasts even before any signs of cancer. Those who test positive for the mutations also have a 50% chance of passing the gene to their children. Here are their stories.